Abstract: In the Loop: Collaborative Model Building to Advance Suicide Prevention for Sexual and Gender Minority Young Adults Experiencing Homelessness (Society for Social Work and Research 31st Annual Conference)

Schedule:

Sunday, January 24, 2027

Union Station 16 (Hilton San Francisco Union Square)

* noted as presenting author

Maiya Hotchkiss, MSW, PhD Student, University of Southern California, Los Angeles, CA

Christina Mair, PhD, Professor, University of Pittsburgh, Pittsburgh, PA

Eric Rice, PhD, Professor, University of North Carolina, Chapel Hill, Chapel Hill, NC

Lindsay Young, PhD, Assistant Professor, University of Southern California, Los Angeles, CA

Mikayla Wallace, Housing Justice Advocate, Southeast Los Angeles Neighborhood Homeless Coalition, Los Angeles, CA

Audrey Margolis, Housing Justice Advocate, The Church: Community Advocacy, Art, and Music Space, CA

John Blosnich, PhD, MPH, Associate Professor, University of Southern California, Los Angeles, CA

Background and Purpose: One in ten young adults ages 18–25 experience homelessness annually in the United States, with approximately 40% identifying as sexual and gender minority (SGM). Suicide is the leading cause of death among young adults experiencing homelessness (YAEH), yet suicide prevention research among SGM YAEH is nascent. Computational prevention approaches (e.g., agent-based modeling) are increasingly used to simulate interventions and policy scenarios, however, preliminary models are often driven by research-based assumptions and rarely include community- experts in research and intervention efforts. This study centers the expertise of SGM YAEH to identify multilevel, dynamic, community-identified cycles and intervention leverage points for suicide prevention through the development of a causal loop diagram.

Methods: This study leveraged collaborative model building (CMB), a participatory complex systems science methodology. Collaborators included (1) 14 SGM YAEH consultants, (2) two community advisory board members and co-facilitators of CMB sessions, and (3) a core modeling team of five scholars and the community advisory board. Over four weekly sessions at a drop-in center, SGM YAEH consultants co- developed a causal loop diagram of causes and consequences of suicidal thoughts and behaviors.

Results: Retention of consultants was 100% over the study period. Consultants identified 14 interrelated variables and 14 feedback loops linking economic instability, traumatic experiences, discrimination, social isolation, substance use, and more in reinforcing cycles shaping suicidal thoughts and behaviors. Findings emphasize a critical phenomenon, ‘performative pathology,’ reflecting an overlooked adaptation of health literacy among YAEH. The diagram highlights community-identified points where interventions may disrupt these cycles, providing actionable insights for affirming, integrated, and trauma-informed interventions that advance equity and well-being.

Conclusions and Implications: The alignment of the community-generated causal loop diagram with existing research and theory, and expansion on understudied variables and relationships, demonstrates that SGM YAEH are lived experts of the problems they face. Centering their expertise produces knowledge that is scientifically rigorous, ecologically valid, and directly applicable to designing policies and interventions. Findings identify economic stability, reducing SGM- and homelessness-related discrimination, and access to low-barrier affirming services as community-prioritized suicide prevention strategies. These results underscore the importance of structural change alongside integrated health interventions and illustrate how participatory research can transform computational prevention science, producing interventions with real-world validity. More broadly, this study demonstrates that engaging community members as knowledge co-producers is essential for social work research that advances health equity.